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Crittenden v. White

Court of Appeals of Georgia, Fifth Division

June 8, 2018

CRITTENDEN et al.
v.
WHITE.

          MCFADDEN, P. J., RAY and RICKMAN, JJ.

          McFadden, Presiding Judge.

         This case involves a legal permanent resident's application for Medicaid benefits. The commissioners of the Georgia Department of Human Services and the Georgia Department of Community Health appeal a superior court decision that Lissia White is entitled to the benefits. The agencies argue that the superior court erred by reversing the final agency decision that White, a British citizen, had to be a legal permanent resident for five years before she applied for Medicaid in order to be eligible for Medicaid benefits. White counters that federal law imposing a waiting period does not apply to her because she entered the United States before August 22, 1996 (the effective date of the legislation establishing the waiting period) has been continuously present in the United States since that time, and has obtained qualified alien status. We agree with White that the five-year waiting period does not apply to her. So we affirm the superior court.

         1. Facts and procedural posture.

The federal Medicaid program
provides subsidies to the states to furnish medical assistance to "families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services." 42 USC § 1396-1. Although a state's participation in the Medicaid program is voluntary, a state that elects to join must administer a state Medicaid plan that meets federal requirements.

Ga. Dept. of Behavioral Health & Developmental Disabilities v. United Cerebral Palsy of Ga., 298 Ga. 779, 779-80 (1) (a) (784 S.E.2d 781) (2016) (citations omitted). Appellant Georgia Department of Community Health is the state agency responsible for administering Georgia's Medicaid program. See 42 CFR § 431.10; see also OCGA § 49-4-142. The Division of Family and Children Services of appellant Georgia Department of Human Services makes Medicaid eligibility determinations. See OCGA § 49-4-3 (b). See generally Cook v. Glover, 295 Ga. 495, 497 (761 S.E.2d 267) (2014).

         White is a British citizen and a legal permanent resident of the United States. She entered the United States in 1991. Her immigration status at that time is not clear. In 1994, White was issued a conditional green card that expired in 1996. In 2014, White was issued another green card that expires March 27, 2024. In 2016, White applied for Medicaid benefits.

         A caseworker with the Division of Family and Children Services denied White's application for benefits on the ground that she had not been a legal permanent resident of the United States for five years. In making this determination, the caseworker examined White's British passport, which bore a stamp reading "Process for I-551 temporary evidence of lawful permanent residence, " as well as a stamp reading "NYC 12-13-94"; White's work permit, which expired in 1996; and her current green card which states "Resident since: 03/25/2014." The caseworker also ran a report using the Systematic Alien Verification for Entitlements ("SAVE") Program through a database of the United States Department of Homeland Security. According to the SAVE report, White's "Date of Entry" was March 25, 2014, which is the date of issuance of her current green card. White appealed the decision to deny her application for benefits.

         An administrative law judge of the Office of State Administrative Hearings affirmed the agency decision denying benefits. White sought final agency review. The Commissioner of the Department of Community Health, through an administrative hearing officer, adopted the administrative law judge's findings of fact and conclusions of law and affirmed the decision to deny benefits.

         White then petitioned the superior court for judicial review. The superior court reversed the final agency decision, finding that the five-year waiting period does not apply to White because she entered the United Suites before the federal legislation's effective date. After we granted their application for discretionary appeal, the agencies filed this appeal.

         2. Standard of review.

         Under the Georgia Administrative Procedure Act, OCGA § 50-13-1 et seq., a superior court "shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact." OCGA § 50-13-19 (h). The superior court may reverse an agency decision only if

substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions, or decisions are: (1) In violation of constitutional or statutory provisions; (2) In excess of the statutory authority of the agency; (3) Made upon unlawful procedure; (4) Affected by other error of law; (5) Clearly erroneous in view of the reliable, probative, and substantial evidence on the whole record; or (6) ...

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